Final CBO score: $940 billion to $143 billion – The key referee in the health care game is the Congressional Budget Office and the CBO’s call on the budgetary impact of the health care legislation definitely influenced the outcome of the contest. On Saturday CBO’s scoring of the of the legislation as reducing the deficit by $143 billion over ten years was a game changer, as several wavering Democrats agreed to support the bill after learning the score. Democratic leaders had gone back and forth with the CBO through several changes in order to produce a bill that cost under a trillion dollars over ten years (the final figure was $940 billion) and that reduced the deficit enough to gain the support of fiscally conservative Democrats. CRFB got into the game, calling for cost control to be paramount – strengthening provisions, such as the excise tax on high-cost insurance plans and the Independent Payment Advisory Board, that have the potential to significantly contain rising health care costs.

Health care triumphs – The health care reform bill that was approved by the Senate late last year cleared the House last night by a 219-212 margin, with no Republican support. President Obama is expected to sign it tomorrow.

Reconciliation bill advances – While they were cutting nets in the House, the reconciliation bill with health care fixes that the House wants the Senate to make advanced to the Final Floor on a 220-211 vote, also with no Republicans voting yes. That bill moves to a Senate venue where it will face opponents like Vote-a-Rama and Point of Order. Even if the Senate does not pass that bill, the original Senate healthcare reform legislation will become law, but many House members voted on the condition that the Senate will make the changes via reconciliation. If the Senate fails to do so, the already tense Senate-House rivalry will make Duke-North Carolina look like a friendly game of croquet.

In Other Action – Health care is not the only game in town. The budget remains a top concern in Washington. Last week a troika of Administration economic officials faced tough questions from the House Appropriations Committee on the President’s FY 2011 Budget and related matters. Work on the budget in Congress has been pushed back because of the health care debate.

Driving to the hoop on fiscal sustainability – Representatives Mike Quigley (D-IL) and Jim Cooper (D-TN) introduced a “Sense of the House” resolution last week to establish fiscal goals for restraining mounting deficits and debt. It calls for the U.S. to reduce the debt to 60 percent of GDP by 2018 and to shrink annual deficits to three percent of GDP by 2018. The Peterson-Pew Commission on Budget Reform recommended the 60 percent by 2018 goal in its Red Ink Rising report in December. CRFB staff discussed getting Congress behind that goal recently with Rep. Quigley. This came as a new Gallup poll indicated that the federal budget deficit would be the top concern for voters 25 years from now.

Small victory – The House on Wednesday passed legislation sponsored by Rep. Ann Kirkpatrick (D-AZ), HR. 4825, which requires amounts remaining in a Member’s Representational Allowance (the office budget for Members) at the end of a fiscal year to be used to reduce the federal debt. It was overwhelmingly approved by a 413-1 vote, a rare show of bipartisanship. It now moves to the Senate. Many Members in attendance at a CRFB dinner in February expressed dismay that office funds they had saved did not go towards reducing the debt and indicated a willingness to address the issue.

Spending limits not a slam dunk in Congress – The Senate took up several measures last week as part of the FAA Reauthorization to address spending, none of which succeeded. An amendment from Sen. Jim DeMint (R-SC) to ban earmarks for one year was tabled (set aside) 68-29. An amendment from Senator John McCain (R-AZ) to prohibit earmarks in years with a budget deficit was voted down 26-70. An amendment from Senators Jeff Sessions (R-AL) and Claire McCaskill (D-MO) to cap discretionary spending for the next three years achieved a majority of votes for the third time, but fell short of the needed 60 votes by a 56-40 margin. An amendment from Sen. James Inhofe (R-OK) to freeze spending at 2008 levels was defeated 41-56. An amendment from Sen. Mark Pryor (D-AR) that was seen as a watered-down version of Sessions-McCaskill because it voids the caps if the president’s fiscal commission fails to agree on recommendations that are approved by Congress also failed 27-70. In one small, bright spot, an amendment from Sen. Russell Feingold (D-WI) to rescind unused transportation earmarks was approved 87-11. On the House side, the Blue Dog Coalition announced a spending caps proposal of their own.